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Commercial Updates

Take Time to Reconcile Your Book of Business

At the close of 2023 Open Enrollment, please take time to reconcile your Individual book of business to ensure you are listed as the Agent of Record (AOR) for all your clients. As a protection to you, AOR changes initiated through the Federally Facilitated Marketplace are not validated until a signed AOR letter is uploaded to our Link system.

To run a book of business report in Select Health Link, hover over Individual on the main landing Page and choose Member Search/Maintenance. To look up an individual, use the search box. To pull a complete book of business report, choose the Search button or Download Book to export the information into an Excel spreadsheet.

If any clients are missing from your commission statement or book of business, please submit an AOR letter via the upload tool in Link. You’ll find the link for Individual Agent of Record Request under Agent Tools on the home page.

This tool determines which AORs are valid before allowing you to upload a completed and signed AOR letter. It will check for:

  • Subscriber eligibility. If the subscriber is ineligible or not enrolled, the AOR will not be accepted.
  • Current AOR. If you are already assigned as AOR, an alert will indicate the submission is unnecessary.

At the end of the upload process, you can print or save a submission receipt page as a PDF for your records.

AOR changes for Your Health Idaho (YHI) enrollments are to be submitted directly through the YHI portal, while AOR changes for Nevada Health Link enrollments are submitted directly through the Nevada Health Link portal.

For a January 1 effective date, please upload AOR letters by January 31. For questions, please contact Kenzie Gray at 801-442-7751 or kenzie.gray@selecthealth.org.

1095-B Forms

As an annual reminder, form 1095-B is no longer required to process a Federal Tax Return. This form is available electronically through the member portal after January 20, 2023, or by member request by calling 844-442-4106.

Group plan members who need to correct information in their 1095-B form should contact their employer. Employers can then submit these changes to Select Health. Members on off-Marketplace plans should contact Member Services with questions at 800-538-5038.

Letter of Authorization (LOA) Policy Update

Beginning January 1, 2023, Select Health will no longer accept LOAs on group business. If data, proposals, current premium billing statements, or other details are needed for an agent that is not the incumbent, the employer group will need to provide it to an agent of their choosing. The only agent authorized to request factors or proposal changes from Select Health regarding existing business is the employer’s currently appointed agent. In order to remain fair and impartial, Select Health will work with the agent and agency selected by the employer. If you have questions, please contact your account manager.

Agent Consolidated Appropriations Act (CAA) & Transparency in Coverage Rule (TiC)

We are continuing to implement requirements associated with the CAA and TiC.

Consumer Price Comparison Tool:

  • Insurers and plans are required to create online consumer tools that include personalized information regarding members’ cost-sharing responsibilities for covered items and services, including prescription drugs. The tool must be an internet-based cost estimator tool that helps estimate personal cost-share liability for medical and prescription drugs.
  • January 1, 2023 - The cost estimator tool must disclose information on 500 items, services, and prescription drugs.
  • January 1, 2024 - The tool must list all covered items and services including prescription drugs.
  • The health insurer is responsible for implementing the requirements for fully insured group health plans.
  • A self-funded group health plan may contract with a third-party administrator to implement some or all requirements of the rule on behalf of the plan.

Prescription Drug Data Collection (RxDC):

  • Under Section 2014 of the CAA, insurance companies and employer-based health plans must submit information about prescription drugs and healthcare spending. CMS recently extended the due date for reporting to January 1, 2023.

Currently, Select Health has a tool available which provides members with most of this information. We are continuously monitoring the legal and regulatory landscape and are compliant with the January 1, 2023 implementation date and on track for full compliance for this requirement prior to the January 1, 2024 implementation date.